Influence of Helicobacter pylori on Hepatitis C Severity and Treatment Response

Helicobacter pylori is a bacteria associated with the development of gastric ulcers.

As reported in the January 2007 Journal of Viral Hepatitis, Japanese researchers conducted a study to examine the impact of H. pylori seropositivity in patients with chronic hepatitis C virus (HCV) infection and its effect on response to treatment with interferon alpha plus ribavirin.

The presence of H. pylori was assessed using a commercially available enzyme immunoassay in serum samples from 93 patients with chronic hepatitis C. Clinical features, HCV markers, and response to interferon-based therapy were compared in patients with and without H. pylori infection.

Results

• Antibodies to H. pylori were detected in 45 of the 93 subjects (48%).

• The median HCV RNA level was significantly lower than in patients without H. pylori infection (495 vs 760 IU/mL; P = 0.013).

• The median platelet count was also significantly lower in the group without H. pylori (128,000 vs 158,000 cells/mm3; P = 0.009).

• H. pylori antibody levels were significantly correlated with fibrosis scores (P = 0.0083), but inversely related to platelet count (P = 0.0037).

• Sustained virological response rates following treatment with interferon plus ribavirin did not differ between patients with and without H. pylori antibodies.

• In a multivariate analysis, the presence of H. pylori (OR 8.61; 95% CI 1.59-46.70) and fibrosis score (OR 30.13; 95% CI 5.44-166.78) were associated with decreased platelet counts during therapy.

Conclusion

"Coexistent H. pylori infection does not demonstrably influence the clinical course of chronic hepatitis C," the authors concluded. "A possible connection between H. pylori coinfection and thrombocytopenia was found during the treatment course, suggesting that preemptive eradication of H. pylori may facilitate completion of treatment and increased sustained virological response."

1/23/07

Reference
T Umemura, H Muto, E Tanaka, and others. Anti-Helicobacter pylori seropositivity: influence on severity and treatment response in patients with chronic hepatitis C. Journal of Viral Hepatitis 14(1): 48-54. January 2007.